[Lymph nodes dissection in esophageal cancer surgery]

Esophageal cancer has high incidence and broad distribution of lymph node metastases. Among the sites of possible lymph node metastasis, the station along the recurrent laryngeal nerve shows the highest rate of lymph node metastasis. For complete lymph nodes clearance, dissection of lymph nodes along the nerves of both sides is essential. The procedure of lymph node dissection along the recurrent laryngeal nerve is a good indicator of the whole quality of the surgery. In order to reduce the morbidity of lymph node dissection, we preserve bronchial artery and pulmonary branches of the vagal nerve. The postoperative complication rate of esophageal cancer surgery is higher comparing other gastrointestinal cancer operations. Pulmonary complication occurs in high rate, and sometimes leads to mortality. On the 2nd and 3rd postoperative day, we have to be very careful for cardiopulmonary condition of the patient. The accuracy and quality of lymph node dissection is closely related to both curability and morbidity.